Provider Demographics
NPI:1922879485
Name:VIGIL, DEBBIE VERONICA
Entity Type:Individual
Prefix:
First Name:DEBBIE
Middle Name:VERONICA
Last Name:VIGIL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 230
Mailing Address - Street 2:
Mailing Address - City:GALLINA
Mailing Address - State:NM
Mailing Address - Zip Code:87017-0230
Mailing Address - Country:US
Mailing Address - Phone:575-638-5491
Mailing Address - Fax:575-638-5571
Practice Address - Street 1:1903 STATE HWY. 96
Practice Address - Street 2:
Practice Address - City:GALLINA
Practice Address - State:NM
Practice Address - Zip Code:87017
Practice Address - Country:US
Practice Address - Phone:575-638-5491
Practice Address - Fax:575-638-5571
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-12
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR37179163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool